Organization · Type 2 NPI

In Home Health LLC

Community Based Hospice Care Agency · Fairview Heights, IL

NPI number 1700105152 Active

Practice location

333 Salem Pl, Suite 165
Fairview Heights, IL 62208-1341

Call (618) 632-0304 Map

Fax (618) 632-0364

Mailing address

333 N Summit St, Dean Shipman
Toledo, OH 43604-2615

Other practice locations

1999 Wabash Ave Ste 105, Springfield, IL 62704-5375 · (618) 632-0304

Specialties and licenses

Taxonomy	Code	License
Hospice and Palliative Medicine (Internal Medicine) Physician	207RH0002X	None listed
Community Based Hospice Care Agency Primary	251G00000X	2001311 (IL)

Community Based Hospice Care Agency: Definition to come...

Another provider at this address

Marleen Louise Burns, ARNPFamily Nurse Practitioner Fairview Heights, IL NPI 1770654493

Other community based hospice care agency providers in Fairview Heights

See all in Fairview Heights →

NPI record

NPI: 1700105152
Entity type: Organization (Type 2)
Issued: May 25, 2010
Last updated: Apr 15, 2022
Status: Active

Other names

<unavail>
Promedica Hospice (fairview Heights) · doing business as
Promedica Hospice (springfield) · doing business as

Authorized official

Mr. Martin D Allen
Director
(419) 252-5734

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1700105152

In Home Health LLC's National Provider Identifier is 1700105152, issued on May 25, 2010. The primary taxonomy on file is Community Based Hospice Care Agency (251G00000X), and the practice location is in Fairview Heights, IL. The record was last updated on Apr 15, 2022.